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Old 06-16-2013, 02:49 PM #1
silverfae silverfae is offline
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Default Is this normal?

My neurosurgeon wants to do ACDF and says that I will not be staying in the hospital at all and I will not be wearing a collar at all. Is that normal? I have been reading people's experiences on here and haven't seen anyone that didn't wear some kind of collar for at least a while after. She is also telling me that I will be back to horseback riding by 2 months post surgery - but from what I am reading here, some people aren't even ready to return to full time work at that time, much less strenuous athletic activities. Any thoughts?

I will say that my neurosurgeon is widely considered to be the best in the area for ACDF and Laminoplasty - and I live right near Dartmouth-Hitchcock Medical Center, so that is saying something. I do think I am going to try to go to Dartmouth to get a third opinion, but even so, I think I will stick with the surgeon I have. I have little doubt that anyone is going to say anything other than surgery at this point.

I also feel strange being here, and I felt very out of place at the neurosurgeon's office. I heard people talking about how they have been in extreme pain for years and can't get surgery, and I feel like...I don't know, I am not in that much pain, my neurological symptoms aren't that bad, and they want me to have surgery at least in the next few months. I feel like there are people in far more need of surgery than me, (and who actually want it) and yet I am the one who has to have it. Am I the only one who feels that way?
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Old 06-17-2013, 01:43 AM #2
LOOKIELOO LOOKIELOO is offline
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Default In a similar boat.....

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Originally Posted by silverfae View Post
My neurosurgeon wants to do ACDF and says that I will not be staying in the hospital at all and I will not be wearing a collar at all. Is that normal? I have been reading people's experiences on here and haven't seen anyone that didn't wear some kind of collar for at least a while after. She is also telling me that I will be back to horseback riding by 2 months post surgery - but from what I am reading here, some people aren't even ready to return to full time work at that time, much less strenuous athletic activities. Any thoughts?

I will say that my neurosurgeon is widely considered to be the best in the area for ACDF and Laminoplasty - and I live right near Dartmouth-Hitchcock Medical Center, so that is saying something. I do think I am going to try to go to Dartmouth to get a third opinion, but even so, I think I will stick with the surgeon I have. I have little doubt that anyone is going to say anything other than surgery at this point.

I also feel strange being here, and I felt very out of place at the neurosurgeon's office. I heard people talking about how they have been in extreme pain for years and can't get surgery, and I feel like...I don't know, I am not in that much pain, my neurological symptoms aren't that bad, and they want me to have surgery at least in the next few months. I feel like there are people in far more need of surgery than me, (and who actually want it) and yet I am the one who has to have it. Am I the only one who feels that way?
Hello Silverfae,

First of all we need more info to properly help you out. What are you having fused (1 level, 2 level etc.), what are your symptoms and what damage does your MRI show.

Second, speaking as a person who has ACDF surgery pending (i'm waiting for the authorization) I questioned my doctor thoroughly. I'm scheduled to have a 1 level fusion at C4-C5 and I was told that with the one level fusion I won't need a collar. As for my hospital stay he said I'll be there at least a day and a half. The first doctor I saw, who wanted to do a 2 level fusion, tried to say my spinal surgery was an outpatient procedure and I'd only be in the hospital 23hours at the most - I walked out his office and never looked back. If your concerned with the time frame you were given by all means ask the doctor why, and even if you accept her answer still get another opinion. You want at least 3 opinions before having major surgery, just for your own peace of mind.

Lastly, when I first started reading all the wonderful and helpful posts on this sight I also stared thinking the same as you, my injury was only 18 months ago and compared to people who have been dealing with their problems for years it seemed at first I was jumping the gun with surgery, but I kept reading and asking questions and I realized that everybody has different pain tolerance and different damage/injuries. When I say the CONSTANT pain in my neck goes from 7-10+ based on what I'm doing the next person might not be in any pain or they might be totally incapacitated from the same injuries. We all sense and feel things differently. I hope this helps you a little. I'm sure some of the senior members of the site will chime in soon.
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Old 06-17-2013, 06:20 AM #3
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Hi silverfae ~ I am particularly upset by her statement that you can RIDE HORSES 2 months after a FUSION! A surgery like that doesn't even BEGIN to fuse until about one YEAR. Why in the world would she want you to risk your surgery by riding horses?

And like Lookieloo said, pain is relative. What you can stand and what I can stand is completely different. Perhaps what YOU can stand would put me on the floor! Or vice/versa.

You may have a very high pain tolerance. Perhaps the condition of your cervical spine is worse than you think because you tolerate pain better than the next person. That may be why you have to have the surgery now. But I still think you should NOT ride horses 2 months after surgery! I would MAKE SURE that I was completely fused before I got on one, and that might be a year or more.

I wish you the very best. God bless and keep us posted on how you're doing. Hugs, Lee
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Old 06-17-2013, 07:30 AM #4
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I have posted all my MRI stuff in a previous post - I have congenital stenosis, DDD, bone spurs and the end result is moderate-severe canal stenosis with myelomalacia resulting in myelopathy - but very little pain. They just want to do the surgery so I don't become paralyzed. The neurosurgeon wants to do a 2 level ACDF (I have 3 bad levels but the third is not as bad and because I am only 34, she doesn't want to fuse me that far at this time.) She says the titanium plate will keep everything together until I am fused, which is why I don't need the collar. It still freaks me out though.

After reading everything on here, I am a bit surprised she said 2 months for riding, but I do know that I have an older friend that she operated on and he got the ok to fall off his horse after 2 months as well and has been back on ever since. I don't ride a horse that I am likely to fall off of, and I don't plan to go doing any jumping or anything, though things do happen - I still may just take the rest of this year off and get back on next spring though. Currently I am training him to drive so I at least have something to do with him until then.
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Old 06-17-2013, 07:33 AM #5
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Default Hi silverfae

I do have a comment. This is just my own observation after being on this site for a number of years. I have also had two spinal fusions. In my opinion, you should not have surgery, until your symptoms and pain are such that it is not bearable. If your MRI says cord inpingment or SEVERE cord compression, that is the time to consider surgery. Surgery is a last resort, when all other measures have been taken. by your own words the pain isn't so bad right now. That tells me, maybe your neuro surgeon is in a bit of a hurry. If three doctors say you need the surgery, well then I would consider it.
No, I don't know anyone returning to horse back riding in such a short time, nor have I heard of anyone going home the day of surgery. Somehow this doesn't seem right. Usually you are in the hospital for a day at least to make sure everything is OK, and to treat for pain if it should present.
Having said all this, even if you like your doctor, it would be good to seek other opinions.
My pain specialist, was the one who told me he could no longer control my pain. He was the one who told me I needed more surgery. That was my deciding factor.
Don't rush into this. Have you tried PT, and some kind of injections?
I am only telling you this as surgery is for the repair of damaged disks, and or structure, that says SEVERE in you MRI. Pain that requires alot of medicaiton, is also a factor. I hope all goes well for you silverfae, and that whatever decision you make is the right one for you. ginnie
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Old 06-17-2013, 09:24 AM #6
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I really have to agree with Ginnie, but since I figured surgery was all set I didn't see any reason to comment on it.

Surgery IS a last resort, and should NOT be gone into unless the pain is next to unbearable OR if the spinal cord is being impinged. If you have 3 surgeons saying that you HAVE to have surgery, then I'd go ahead with it, but not until.

You have NO IDEA what happens after spinal surgery. You are NEVER the same, regardless of what people say. You are a changed person, and there is the danger of the "Domino Effect" which happens all the time. It's no joke. It means more surgery down the line.

I certainly wouldn't do ANY kind of horse riding, whether it's in a cart or on the horse itself until I was completely fused. Any kind of bouncing like that can completely wreck your fusing.

If I were you, I'd re-consider this whole surgery idea. Personally, I'd NOT have it done at this time. I'd wait until I just couldn't stand it anymore. Best of luck and God bless. Hugs, Lee
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Old 06-17-2013, 11:13 AM #7
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I guess maybe I am not saying it correctly or something - my spinal cord is flattened and bruised (myelomalacia) from the damage in my neck. I have flare ups of pain from time to time that are pretty intense and last about a week, and a bit of pain all the time that limits my ROM. But I have loss of fine motor control in my hands, tingling in my hands off and on every day, bladder issues, balance issues, feel like things are crawling up my legs all the time, and my arm and leg on my left side randomly "goes to sleep" during the day. It doesn't hurt, but the doctors say I will wake up with some kind of paralysis at some point if I don't have surgery and they only hope that these things will get better if I have surgery now, but have advised that they probably won't. So, should I wait until I am completely paralyzed for surgery?
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Old 06-17-2013, 01:13 PM #8
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Sorry to hear of all that is going on with you. I would think it would be best to have surgery sooner rather than later. Surgery will help to prevent further neurological damage. Myelopathy doesn't usually get better on its own.

I am 38 and have always been very active. It was the first neurosurgeon that I saw that made me stop running and using kettlebells. My main symptoms that brought me to the doctor in the first place were tingling and numbness in my right hand that wouldn't go away (which did progress to my left hand a little). I had slight pain but it wasn't unbearable. However, I was diagnosed with cervical spondylosis with myelopathy and radiculopathy (my MRI also showed cord signal changes suggestive of myelomalacia). My spinal canal at c5-6 measured between 5 & 6 mm. The 2nd neurosurgeon I saw told me in layman's terms that I was crushing my spine. There really wasn't a choice in the matter which sounds somewhat like your case. I had a 3 level ACDF in March. I'm still wearing a bone growth stimulator and in the healing process, so I'm not a good person to talk to about long-term results but so far so good ~ not perfect but overall good.

Good luck to you. Let us know what you decide to do. Take care.
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Old 06-17-2013, 08:08 PM #9
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Default Hi silverfae

No, if there is a real danger of being paralized you need to do the surgery. That was what happened to me. However I also had the domino effect, and required more surgery 6 years after. C6-7 is the baddie, that can do this.
Bladder troubles however usually are not from the cervical area, but lower lumbar area. I am curious as to which verterbre your doctor is considering doing. Did you go for other opinions? No matter what you decide, that other opinion is really important. I failed to do this, and didn't know the condition of the verterbre above the origionl site of my fusion at C6-7. All the ones above it failed, as they were damaged at the time of the first fusion. I was not told, and I didn't read or understand my MRI. I trusted that first neruo surgeon. BAD mistake, and I paid the price. Because this happened to me, when I talk to people I try to make sure they get that other opinion, and actually understand their MRI's. I came to NT, freaking over having to go through a really extensive surgery as I reversed the curve of my spine during that 6 year interval. Just make sure you have all your facts OK? Just be careful and get the other opinion. Then Go for it, and I do wish you all the very best.
There is hope, remember these things can and do turn out OK. My own fusion is just fine silverfae, and I don't regret doing that second fusion. I turned out OK, and have very little pain considering all that was done. Let me know what happens., I truely care. Leesa does too. ginnie
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Old 06-17-2013, 10:11 PM #10
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They are going to fuse C3-C5 - she did comment that my damage is much higher than the normal wear and tear areas. I have some DDD in C5-C6 but she doesn't want to fuse 3 levels on me because I am only just barely 34. But She did say for sure that my urinary issues were due to the neck - you can have cauda equina issues with lumbar stenosis, but she said that everything from the bottom of my chin down is fair game with my stenosis and that there is no end to the combination of weird things it can cause. Sometimes I feel like there is ice water on parts of my body, other times my whole calf goes tingly, and others I get a vibrating sensation in various places. And trying to work on some jewelry tonight (not to mention trying to type without typos) I am realizing that my fine motor skills have deteriorated even beyond where they were when I had to leave my job in April. But that doesn't hurt, so it's hard for me to see it in the same terms as all the people here and in the dr office who are having so much pain.

I have had 2 opinions and I am working on a third, but I suspect my insurance will not pay for it and I doubt that I will get any different information. I am guessing I will have a domino effect and have to have fusion for the C5-C6 area at some point since it is already damaged and is in the high wear and tear area, but I guess if I can keep some mobility for a while, I will take it. I have a 5 year old I have to run around after, and I would like to be able to keep up with her as long as possible =)
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